Physician let a colleague treat you

By Zeba Hisam

TODAY I am writing this while waiting for my turn for physiotherapy for my right hand carpal tunnel syndrome. I had been having severe pain that became worst on twisting movements and pulling or bearing weight on this hand. First I took a painkiller regularly without any benefit then kept on complaining about pain and was scolded by my mother and elder sister to consult a doctor and not to treat myself. I got all my lab investigations done which came out to be normal ( CP, ESR, CRP, uric acid, RA factor and T3, T4, TSH and the x-ray of my wrist). I was convinced that it was carpal tunnel syndrome as I previously got a persistent parasthesia on my right hand so I got an appointment with my teacher, Professor of neurology, Dr. Abdullah, who endorsed my diagnosis and sent me to this amazing physiotherapy Center named “Neurology & Falij care Center”! He advised me to get my physiotherapy done by the specific lady physiotherapist. So it’s my third session today and I do the exercises advised by her regularly at home multiple times. I hope and pray that improvement will come soon. 

I am writing this because I want to warn and advice all doctors who are even specialist in their own specific fields, to please consult a doctor if you have any complaint and do not let yourself be treated by yourself considering yourself as a self sufficient doctor! As we take the history of a patient then we examine the patient physically in a proper set up of our clinics to make a diagnosis so like that, we also need to be examined in the same manner by another professional doctor and trusting that doctor and following the advice given!

I give an example of my doctor friend who got fever with sore throat. She followed her own advice by assuming a viral infection so didn’t take any medicine and neither got any tests done. After a few days she was sick enough to not come out of bed. She mentioned this to another doctor who met her by chance. That doctor said that her husband had the same sickness and he got well by a five day course of tablet Levofloxacin. On her advice, she took that medicine and deteriorated further. I also met her by chance and found her unable to talk and walk. She was in need to be on a hospital couch to be examined by me or any other doctor. Her super spirits kept her working and she told me that everyday her fever settles with panadol tablets and she comes to work! It was beyond my comprehension! She consulted me on her way by standing in the corridor and asked me for some appropriate medicine? How could I answer that without even taking her proper history and physical examination? This I am telling you about a specialist doctor’s behaviour on illness and not of a layperson! 

One of a colleague gynaecologist working in the same hospital,  came to me one day with complaints of dizziness and feeling of doom. I checked her vitals and found her blood pressure to be 200/120 mmHg. I advised her to get admitted and get her tests done but she said there is no history of hypertension and lately she had a few episodes otherwise she was fine and was not taking any medicine. Although every time she had this episode she used to go to the emergency department to lie down on a bed with a sub lingual Capoten tablet given by emergency duty RMO and after half an hour, she would return to her  OPD for examining her patients! (How could she ignore her patients)! She never checked her blood sugar level or lipid profile or electrolytes or urea and creatinine! She was so oblivious of hypertension’s complications! So at times we can give only a sincere advice and let the doctor decide what he has/she to do! 

So doctors! Take a break if you are sick and consult another doctor to help you by examining and treating you with an appropriate diagnosis!

The writer is a Consultant Physician at the Zubaida Medical Center, Karachi

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Right vs wrong

IN a society as morally perverse and corrupt as ours, does a centre of ethics have any relevance? A cynic’s answer would be a resounding ‘none whatsoever’. The idealist/reformer would say, ‘all the more’. That is a dilemma that faces all activists in this country seeking to light the spark of change.

In this context, the SIUT’s Centre for Biomedical Ethics and Culture (CBEC) faces a daunting challenge. It has been struggling for the last 13 years to introduce an ethical perspective not just in healthcare but also in the non-medical sector. Its endeavours became meaningful and received international recognition when last week WHO declared the CBEC a Collaborating Centre for Bioethics — one of the eight to receive that prestigious status worldwide. Continue reading “Right vs wrong”

Blame rests on ….

By Zubeida Mustafa

IN August, Pakistan will be celebrating the 70th anniversary of its independence. This has understandably spawned a spate of soul searching. It was in abundance at the Karachi Literature Festival. The session titled “Pakistan: a fragile state or resilient nation” focused entirely on the state and didn’t address the issue of resilience at all. The state was held responsible for all the evils that have befallen us.

Unsurprisingly, the speakers concentrated on identifying the villain of the piece that was said to be the ‘state’ — an abstract term. As the discussion proceeded, the state became the “invisible state” and then the “deep state”. The audience clearly understood that these terms referred to the army which has played a central role in determining Pakistan’s destiny. Continue reading “Blame rests on ….”

The secret of success

By Zubeida Mustafa

Why is the SIUT a success story when other health institutions in the public sector in Pakistan have failed? This question is frequently asked by people who are wonderstruck by the SIUT’s performance. Few can believe that this immaculate  hospital that sprawls before them is in the public sector. It has taken it 40 years to reach its present greatness. And it is still growing.

The only feature that betrays its ownership is the over-crowding you see there. Being in the public sector, this tertiary healthcare institution attracts all and sundry. Moreover it is a hospital that is affordable and actually works, where people are treated and recover from their illness.  Continue reading “The secret of success”

Message of hope?

 

By Zubeida Mustafa

IN these times of despair, even the dead can give us hope and inspiration. That is the powerful message that emerged from the Orangi Pilot Project-Research and Training Institute’s forum on Jan 22. It was organised to commemorate the birthday of Perween Rahman who was shot fatally in March 2013.

Why was Perween killed? It might sound bizarre but the fact is that there are vested interests in our society who feel threatened by people who work for the poor. That was confirmed by SP Akhtar Farooqi who said on the occasion that the murder was not motivated by personal enmity but by economic factors. Continue reading “Message of hope?”

Loss of dignity

By Zubeida Mustafa

A FRIEND sent me his greetings on New Year with this verse: “Apnay haathon say dastar sumbhaloon kaisay/ Donon haathon mein kashkol pakar rakha hai.” (How should I hold up my turban when I hold the begging bowl with both my hands?)

The truth of this verse hit me when a news item in this paper reported the proceedings of the Senate recently. The government had come under fire from a PTI member for piling up external and domestic debts to such proportions that servicing them was becoming impossible.

One should not dismiss this as political gimmickry to embarrass the ruling party. After all, which party in Pakistan has even attempted to be self-reliant by adopting austerity as a policy to reduce the government’s dependency on loans? With few parties remaining in office for too long, every ruler spends money with abandon knowing that the chickens will come home to roost when he will not be around to cope with the problem. Continue reading “Loss of dignity”

A hill station in decay

The snow covered Thandiani mountaintop in the background  can no more be seen from a point of one's choice due to buildings like this one.
The snow covered Thandiani mountaintop in the background can no more be seen from a point of one’s choice due to buildings like this one.

By: Nasser Yousaf

guest-contributorAbbottabad. The name sounds romantic. But romantic it is no more. The small hill station, named after its first district administrator, is not even a shadow of its former glory. Sir James Abbott had been so greatly enamoured by the pristine beauty of his place of posting and temporary abode that he wrote an emotional poem in its praise. Continue reading “A hill station in decay”

No trashy issue

TWO seemingly insignificant events could amount to the writing on the wall for our municipal administrators all over the country. It is plain, the public will no longer turn a blind eye to poor sanitation. People are now beginning to understand the implications of environmental pollution.

Recently, the inhabitants of a village in Fatehjang tehsil (Punjab) protested against the garbage dump which the district municipality had created near their homes. Some of them actually travelled to Islamabad to meet the director of the National Commission of Human Rights to lodge their complaint. They were not happy with the odour that pervaded their homes. Even more encouraging was the fact that the inhabitants of neighbouring villages refused to allow the DMO to pile garbage near their homes when he tried to shift the dumping site. Continue reading “No trashy issue”

Consulting a doctor

Dr  Zeba Hisam (MBBS FCPS)

zubeida-3-001-1I am always amazed at people who do not have a family physician from whom they can seek medical advice, when they are ill No matter what is the nature of their health problem, there is no family physician to decide if there is any need for a referral to a specialist. Even patients who are educated and are from the privileged class  declare proudly that they do not need a doctor as they have not suffered from any disease.  In this scenario, if any emergency arises, they panic and seek an immediate appointment from the most renowned and famous specialist they can think of.

My observation is that the more affluent and educated a person is, the more awkward he feels in seeking medical advice. He decides himself which specialist he should consult. His choice sometimes proves to be wrong.

Continue reading “Consulting a doctor”

Eyes on diabetes

 

banting-top2_World Diabetes Day, 14 November, is a day to create awareness on diabetes, a metabolic disorder with a fast rising incidence. The International Diabetes Federation (IDF) and World Health Organization launched the WDD in 1991. This date   was selected to pay homage to the co-discoverer of Insulin, Dr Frederick Banting whose birthday fell on that day. Every year a new theme is selected for the WDD. Most countries of the world observe the day by organizing programmes participated by the general public, health care providers and policy makers. It is a day to raise awareness among all, old and young to fight against the disorder.

zubeida-3-001-1By Dr Fatema Jawad

Mr X’s eyes have been giving him trouble of late. He goes to the doctor. After an examination and some laboratory tests he is informed that he has diabetes. The news comes as a shock to him.

But not to his doctor. It is now known that diabetes is a fast growing metabolic disorder. There are 415 million adults with diabetes worldwide. Simply put,  10.7 percent of the global adult population is living with it. IDF has estimated that by the year 2040 this figure will rise to 642 million or 11.2 percent.. This means one in ten adults has diabetes. About 80 percent of the people with diabetes live in the middle and low income countries and a majority are between 40 and 59 years of age, the most productive years of life. (International Diabetes Federation Diabetes Atlas, 2015) Continue reading “Eyes on diabetes”